US6626838B2 - Blood flow meter apparatus and method of use - Google Patents

Abstract

A strobed blood flow meter provides periodic measurements of blood flow velocity or volumetric blood flow over a cardiac cycle at reduced average power consumption, which is advantageous for reducing battery size, and extending device battery life, such as in an implantable application. Continuous wave Doppler, pulsed Doppler, laser Doppler, transit time, electromagnetic flow, and thermal dilution techniques are included. Strobing provides higher level excitation during active periods, which improves signal-to-noise ratio, and provides a low power standby mode during an idle time between active periods. The invention may be used for chronic or acute applications. Doppler or other signals may be telemetered from an implanted portion of the flow meter for further signal processing to extract velocity or volumetric flow. Alternatively, such signal processing is also implanted, such that the velocity signal can be telemetered to an remote monitor.

Description

CROSS REFERENCE TO RELATED APPLICATION(S)

This application is a division of U.S. patent application Ser. No. 09/452,332, filed on Nov. 30, 1999, which in turn is a continuation of U.S. patent application Ser. No. 09/179,042, filed on Oct. 26, 1998, now U.S. Pat. No. 6,063,034, which is a division of U.S. patent application Ser. No. 08/744,360, filed on Nov. 7, 1996, now U.S. Pat. No. 5,865,749, the specifications of which are incorporated herein by reference.

FIELD OF THE INVENTION

This invention relates to estimation of fluid flow, and more particularly to a chronic or acute measurement of blood flow in a blood vessel.

BACKGROUND

There are many applications in clinical and research medicine in which measurement or estimation of volumetric blood flow within a blood vessel is desirable. One method of making such measurements uses ultrasonic Doppler techniques to measure blood flow velocity and thereby estimate volumetric blood flow. Velocity of an object is often measured using the Doppler effect Single frequency ultrasonic energy is transmitted into an area of tissue containing the blood flow to be measured. This insonification of the area is typically referred to as illumination Resulting ultrasonic energy is reflected, or backscattered, from the illuminated area. Energy reflected from moving targets, such as fluid and blood cells, will be shifted in frequency from the illuminating frequency according to the well-known Doppler effect The Doppler shifted frequency provides a measure of the blood flow velocity.

In clinical and research applications, it is often necessary to study blood flow for an extended period of time. Thus, in ambulatory living organisms, such as animal or human subjects, there is a need in the art to provide a battery-powered ultrasonic Doppler blood flow meter for measuring blood flow velocity for an extended period of time, allowing a human or animal patient freedom of movement during the study and minimizing the need for supervision by the clinician. There is also a need in the art to provide a small, low-power ultrasonic Doppler blood flow meter that is suitable for implantation in a human or animal subject. There is a further need in the art to provide an implantable ultrasonic Doppler blood flow meter that maintains adequate signal-to-noise (SNR) ratio for accurate velocity estimation.

SUMMARY

The present invention includes a method and apparatus for estimating blood flow or blood flow velocity in a blood vessel over a period of time. According to the method, at least part of the measurement circuits used to estimate blood flow are automatically activated only during the time an estimate is being obtained. At least part of the measurement circuits are automatically deactivated during the time an estimate is not being obtained These steps are performed repeatedly to provide a sequence of blood flow estimates forming a blood flow waveform indicative of blood flow. More than one estimate is typically required to obtain a waveform representative of the blood flow.

The steps of activating and deactivating at least part of the measurement circuits is repeatedly performed sufficiently frequently, either periodically or at irregular intervals, such that the blood flow waveform substantially represents the variable blood flow. Power to at least a portion of the measurement circuits is reduced or interrupted while the measurement circuits are deactivated.

Measurement of blood flow can be obtained through various blood flow measurement techniques, including: continuous wave (CW) Doppler flow measurement, pulsed Doppler flow measurement, laser Doppler flow measurement, transit time flow measurement, thermal dilution flow measurement, electromagnetic flow measurement, or other suitable flow measurement technique.

In several embodiments, a basebanded Doppler-shifted signal provides the blood flow estimate. In other embodiments, a blood flow output signal is derived from the basebanded Doppler-shifted signal and provided as the blood flow estimate.

Thus, the present invention provides a strobed blood flow meter, such as an implantable strobed ultrasonic Doppler blood flow meter, having reduced average power consumption, which is advantageous for reducing battery size, extending battery life, and improving signal-to-noise ratio.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings, like numerals describe substantially similar components throughout the several views.

FIG. 1 is a block diagram of one embodiment of the invention.

FIG. 2 is a block diagram illustrating one embodiment of the mixer of FIG. 1 in more detail.

FIG. 3 is a block diagram illustrating one embodiment of the transducer of FIG. 1 in more detail

FIG. 4 is a block diagram illustrating one embodiment of the control circuit of FIG. 1 in more detail.

FIG. 5A is a graph illustrating generally voltage vs. time waveforms for one embodiment in which the invention is operated.

FIG. 5B is a graph illustrating generally a velocity vs. time signal in operation of the embodiment of FIG. 5A, but on a compressed time scale with respect to the illustration of FIG. 5A

FIG. 6 is a block diagram illustrating one embodiment of the present invention in which certain components are turned off during the idle period.

FIG. 7 is a block diagram illustrating another embodiment of the present invention in which certain components are turned off during the idle period.

FIG. 8 is a block diagram illustrating a further embodiment of the present invention in which certain components are turned off during the idle period.

FIG. 9 is a block diagram illustrating in more detail the control circuit of FIG. 8 in more detail.

FIG. 10 is a block diagram illustrating an embodiment of the present invention including an impedance matching network.

FIG. 11 is a block diagram illustrating an embodiment of the present invention including a signal processor.

FIG. 12 is a block diagram illustrating one embodiment of the signal processor of FIG. 11 in more detail.

FIG. 13 is a graph generally comparing the strobed continuous wave and pulse Doppler ultrasonic frequency waveforms.

FIG. 14 is a block diagram illustrating one embodiment of the present invention using transit time techniques of blood flow velocity estimation.

FIG. 15 is an end view of the embodiment illustrated in FIG.14.

DETAILED DESCRIPTION

In the following detailed description, reference is made to the accompanying drawings which form a part hereof, and in which is shown by way of illustration specific embodiments in which the invention may be practiced. These embodiments are described in sufficient detail to enable those skilled in the art to practice the invention, and it is to be understood that the embodiments may be combined, or that other embodiments may be utilize and that structural, logical and electrical changes may be made without departing from the spirit and scope of the present invention. The following detailed description is, therefore, not to be taken in a limiting sense, and the scope of the present invention is defined by the appended claims and their equivalents.

The present invention provides a strobed blood flow meter useful for chronic or acute estimates of blood flow or blood flow velocity and having reduced average power consumption, which has advantages that include reducing battery size and extending battery life. As discussed and defined herein, estimating volumetric blood flow and blood flow velocity are understood as interchangeable concepts, since estimates of volumetric blood flow are obtained from estimates of blood flow velocity by multiplying blood flow velocity with a known constant cross-sectional area of a blood vessel. When the cross-sectional area of the blood vessel is unknown, a signal proportional to estimates of blood flow can still be provided from estimates of blood flow velocity since the cross-sectional area of the blood vessel is assumed to be relatively constant.

As used herein, the term “strobing” is defined as repeatedly estimating blood flow velocity during a period of interest, as discussed below. In a living organism having a circulatory system with a cardiac cycle, which is defined as the period between successive heartbeats, the period of interest for strobing may be one or more such cardiac cycles. However, it is also desirable to repeatedly estimate blood flow velocity over a period of interest when no cardiac cycle is present. For example, certain embodiments of an artificial heart pump may be implemented without the periodic pulsing associated with a heartbeat. In such systems, it may still be desirable to repeatedly estimate blood flow velocity over some other period of interest.

As will be described in detail below, the present invention encompasses strobing or automatically activating certain portions of the blood flow meter during an active period in order to obtain an ultrasonic Doppler blood flow velocity estimate, and later automatically deactivating these portions of the blood flow meter during an idle time between such estates. As a result, average power consumption is advantageously reduced. Strobing according to the present invention includes a wide variety of blood flow measurement techniques, including, but not limited to: ultrasonic Doppler blood flow measurement, such as both continuous wave (CW) and pulsed Doppler blood flow measurements; transit time measurements; electromagnetic flow measurements; thermal dilution measurements; and laser Doppler measurements, each of which is described further below.

FIG. 1 is a block diagram illustrating one embodiment of the present invention. In FIG. 1, strobed ultrasonicblood flow meter100 is capable of being implanted in a human or animal subject for measurement of blood flow inblood vessel105.Blood flow meter100 comprisesoscillator110, which is a sine or square wave oscillator operating at a carrier frequency in an ultrasonic region of the frequency spectrum, typically in the 5-20 MHz range, though other frequencies are also possible. The ultrasonic sine or square wave output signal ofoscillator110 atnode115 is referred to as a carrier signal. The carrier signal frequency atnode115 is in the ultrasonic frequency range, and is electrically coupled to acontrol circuit120 at controlcircuit oscillator input125.Control circuit120 produces at control circuit output130 a resulting electrical strobed ultrasonic-frequency signal (shown assignal145V in FIG. 5A) which is electrically coupled toamplifier input135 ofpower amplifier140 throughnode145. In response,amplifier140 produces a resulting electrical strobed amplified ultrasonic-frequency signal atamplifier output150, which is electrically coupled throughnode165 to transducerelectrical input155 oftransducer160. In response,transducer160 provides, attransducer ultrasound output170, ultrasonic energy that is mechanically or acoustically coupled to tissue includingblood vessel105. In this patent application, providing ultrasonic energy, insonifying, and insonating, are all referred to generally as illuminating.

Illumination ofblood vessel105 results in a reflected Doppler-shifted ultrasound signal, also referred to as a backscattered signal, that is received attransducer ultrasound input175, and converted bytransducer160 into a Doppler-shifted electrical signal at transducerelectrical output180. The Doppler-shifted electrical signal is electrically coupled throughnode195 toreceiver input185 ofreceiver190, which provides a buffered Doppler-shifted signal in response thereto atreceiver output200.

Mixer205 receives the buffered Doppler-shifted signal atmixer input210 throughnode215.Mixer205 also receives throughnode115 the carrier signal ofoscillator110 atmixer oscillator input220.Mixer205 performs a demodulation function by quadrature mixing, as described below, producing an in-phase (I) signal at in-phase (I)output225 and a phase-shifted (Q) signal, which is 90 degrees out of phase with respect to the I signal, at phase-shifted (Q)output230. The I and Q signals each have components that include difference and sum frequency components that are approximately equal to the respective difference and sum of the frequencies of the carrier signal and the buffered Doppler-shifted signal. The I and Q signals may also contain a carrier frequency component, also referred to as carrier feedthrough.

The I signal is electrically coupled throughnode235 to a first lowpass filter input240 of firstlow pass filter245. Firstlow pass filter245 removes the carrier feedthrough and the sum frequency components of the I signal, and provides the difference frequency component at the first lowpass filter output250. The difference frequency component at the first lowpass filter output250 is referred to as the basebanded in-phase Doppler signal or the basebanded I Doppler signal. Similarly, the Q signal is electrically coupled throughnode255 to a second lowpass filter input260 of secondlow pass filter265. Secondlow pass filter265 removes the carrier feedthrough and the sum frequency components of the Q signal and provides the difference frequency component at the second lowpass filter output270. The difference frequency component at the second lowpass filter output250 is referred to as the basebanded phase-shifted Doppler signal, or the basebanded Q Doppler signal.

The basebanded I and Q Doppler signals are electrically coupled throughrespective nodes275 and280 to respective inputs oftelemetry circuit285. In one embodiment, the basebanded I and Q Doppler signals are remodulated with a telemetry carrier frequency for transmission to aremote telemetry device282, such as an external telemetry receiver. In another embodiment, as described below, an analog velocity output signal is produced, which is encoded, such as by pulse position modulation, for transmission toremote telemetry device282. Thus,telemetry circuit285 allows transmission of the signals corresponding to the basebanded I and Q Doppler signals from implantedblood flow meter100 to aremote telemetry device282 for further precessing. In one embodiment, this further processing includes velocity determination according to the well-known Doppler equation, illustrated in Equation (1).$\begin{array}{cc}v=\frac{f_dC}{2f_c\cos \theta }& \left(1\right)\end{array}$

In Equation (1): v is the blood flow velocity to be determined; f_dis the (basebanded) received Doppler shifted frequency reflected from the blood flow, C is the speed of sound in the medium, e.g. tissue; f_cis the carrier frequency; and θ is the angle formed by the velocity vector of the blood flow and the path along which the illuminating ultrasonic energy is provided.

FIG. 2 is a block diagram illustrating one embodiment ofmixer205 in more detail. In FIG. 2,mixer205 includes quadrature phase splitter300, first multiplier305, andsecond multiplier310. Splitter300 receives, throughnode115, the carrier signal atsplitter input315, and produces in response thereto a resulting in-phase carrier signal atnode320 and a phase-shifted carrier signal atnode325 that is phase-shifted by 90 degrees with respect to the in-phase carrier signal. The in-phase carrier signal atnode320 and the phase-shifted carrier signal atnode325 are substantially quadruture balanced, i.e. they are substantially matched in amplitude, and have a phase difference which is very close to 90 degrees. The buffered Doppler signal atnode215 is multiplied at first multiplier305 by the in-phase carrier signal atnode320 to produce the I signal atnode235. The buffered Doppler signal atnode215 is also multiplied atsecond multiplier310 by the phase shifted carrier signal atnode325 to produce the Q signal atnode255.

FIG. 3 is a block diagram illustrating one embodiment oftransducer160 in more detail, in relation toblood vessel105. In FIG. 3,transducer160 includes ultrasound transmittransducer330 and ultrasound receivetransducer335. Transmit andreceiver transducers330 and335 are preferably single piston piezoelectric transducers, comprised of materials such as lead zirconate titanate (PZT) crystal or composite materials. Other piezoelectric crystal, ceramic, or polymer, or any other suitable transducer may also be used.

Transmittransducer330 receives the electrical strobed amplified ultrasonic-frequency signal atinput155 and provides, or launches, continuous wave (CW) ultrasonic energy attransducer ultrasound output170 for illumination ofblood vessel105. Illumination ofblood vessel105 results in a reflected Doppler-shifted ultrasound signal attransducer ultrasound input175 that is received by receivetransducer335 and converted into an electrical received Doppler-shifted signal at transducerelectrical output180. In FIG. 3, separate transmit and receivetransducers330 and335 are used for simultaneously illuminating and receiving CW Doppler ultrasound. However, it is understood that a single transducer could also be used for sequentially illuminating and receiving pulsed Doppler ultrasound, as described below.

FIG. 4 is a block diagram illustrating one embodiment ofcontrol circuit120 in more detail. In FIG. 4,control circuit120 includes sine wave tosquare wave converter350,digital control logic355, andstrobing switch360.Converter350 receives the carrier signal atnode115 and provides to digital control logic355 a square wave clock signal atnode365, which can be divided down to lower frequencies if desire.Converter350 is omitted ifoscillator110 is a square wave, rather than a sine wave oscillator.Logic355 provides a periodic strobing control signal atnode370, also available at strobingcontrol signal output371, to control the conductance of the carrier signal atnode115 throughstrobing twitch360 to controlcircuit output130. However, the periodic strobing control signal atnode370 could alternatively be provided at irregular intervals. A resulting electrical strobed ultrasonic-frequency signal is provided throughnode145 for amplification byamplifier140 and conversion into ultrasound energy bytransducer160.

FIG. 5A is a voltage vs. time graph illustrating generally timing in one embodiment in which the present invention is operated. FIG. 5A includesstrobing control signal370V atnode370 and the strobedultrasonic frequency signal145V atnode145. A corresponding velocity vs. time graph is illustrated in FIG. 5B, but with time illustrated on a compressed time scale with respect to that in FIG.5A. In FIG. 5A,strobing control signal370 is a periodic control signal having a corresponding strobing period, t_strobe. The strobing period is comprised of an active period, t_on, and an idle period, t_off.

During the active period of thestrobing control signal370V, the carrier frequency signal atnode115 is conducted tonode145 through thestrobing switch360, as illustrated during the corresponding portion of the strobedultrasonic frequency signal145V. During the idle period of thestrobing control signal370V, the carrier frequency signal atnode115 is isolated fromnode145 by thestrobing switch360, as illustrated during the corresponding portion of the strobedultrasonic frequency signal145V.Blood vessel105 is illuminated during each active period of thestrobing control signal370V, as illustrated in FIG.5A. Velocity is determined near the end of each active period of thestrobing control signal370V, such as at times t₁, t₂, and t₃, as illustrated in FIGS. 5A and 5B.

Blood velocity will vary depending on the size and physiological location of theblood vessel105 being measured. Blood velocity will also vary as a function of time during the cardiac cycle, i.e. during and between successive heartbeats. One embodiment of the present invention uses a programmably adjustable strobing frequency, which is the inverse of the strobing period. The strobing frequency should be high enough to provide a representative estimated velocity vs. time waveform both during the cardiac cycle and over many cardiac cycles. For example, in most larger mammals, heart rate varies from between 40 to 200 beats per minute. A strobing frequency of 50 Hz respectively provides 75 and 15 estimated velocity data points for each of these respective heart rates. For smaller mammals, such as rats, heart rate may approach 400 beats per minute. Increasing strobing frequency to 100 Hz would still allow 15 estimated velocity data points for this case.

The particular strobing frequency may be selected to obtain the desired time resolution of velocity estimates. The desired time resolution of velocity estimates may in turn be selected to accommodate the expected rate of change of blood flow velocity in the blood vessel. The rate of change of the blood flow velocity is typically higher for anarterial blood vessel105 that is more proximal to the heart than for anarterial blood vessel105 that is more distal from the heart or for avenal blood vessel105. As set forth above, t_strobewill exceed t_on. But the maximum value of t_strobewill depend on many factors, including whether an accurate reconstruction of the velocity waveform is needed or whether the velocity estimates are used only to determine blood flow, such that fewer estimates per cardiac cycle may suffice.

In one embodiment, active period, t_on, is minimized to minimize average power consumption or to obtain other advantages, as described below. However, the minimum active period is typically longer than some combination of: a system bandwidth; a stabilization time; and a mean-frequency estimation time.

The system bandwidth is defined as the inverse of the maximum expected basebanded I and Q Doppler signal frequencies, which can be calculated from the well-known Doppler equation for a particular blood velocity.

The stabilization time is the time required to power up and stabilize certain electronic circuits which are powered down during the idle period. The required stabilization time may be dominated by, for example, the filter time-constants of first and second low pass filters245 and265, if these filters were powered down during the idle period. In another example, the required stabilization time may be dominated by the charging of a power supply output capacitor from which power is supplied to those electronic circuits that were turned off during the idle period. Separate control signals may be provided to individual electronic circuits to tailor the time that the circuits are powered to meet their individual stabilization requirements. For example, first and second low pass filters245 and265 may be turned on prior to providing the electrical signal to drivetransducer160 to accommodate longer stabilization time requirements of first and second low pass filters245 and265.

The mean frequency estimation time is determined by the number of samples of the basebanded I or Q Doppler signals atrespective nodes275 and280 that must be acquired to accurately estimate the blood velocity for a particular velocity estimate. The mean frequency estimation time depends, in turn, on the particular mean frequency estimation technique used. In one embodiment, sophisticated digital signal processing techniques are used to extract a relatively accurate mean frequency estimate from as few as 8 of the samples. In another embodiment, zero-cross detection techniques are used to provide a root mean square (rms) reading of mean frequency from more than 100 samples.

The present invention uses strobed ultrasonic energy, which advantageously reduces its average power consumption. This is particularly important when power is drawn from a fixed resource, such as a battery, which is implanted in vivo together with the electronics ofblood flow meter100 and cannot be easily replaced. In such situations, the reduced average power consumption of the present invention is critical for extending battery life ofblood flow meter100. The average power consumption of the present invention is illustrated by Equation (2).$\begin{array}{cc}\mathrm{Power}=\frac{P_{\mathrm{on}}t_{\mathrm{on}}+P_{\mathrm{off}}t_{\mathrm{off}}}{t_{\mathrm{strobe}}}& \left(2\right)\end{array}$

In Equation (2), P_onis the power consumption during the active period and P_offis the power consumption during the idle period. As explained below, most of the electronics ofblood flow meter100 are powered on during the active period, but only a subset of these electronics are powered on during the idle period For this reason, P_onexceeds P_off. Thus, as illustrated in Equation (2), average power consumption is minimized by: reducing the duration of the active period; and, increasing the strobing period; and, decreasing both P_onand P_off, particularly P_on.

FIG. 6 is a block diagram illustrating one embodiment of the present invention in which only amplifier140 andtelemetry285 are turned off during the idle period. The strobing control signal atnode370 is electrically coupled to switchably control the conductances between each ofamplifier140 andtelemetry285 blocks and their respective power supplies.Transducer160 typically does not draw any bias current, but use of any transducer that does draw bias current could similarly have its bias current switchably controlled by strobingcontrol signal370. By leaving other blocks powered during the idle period, stabilization time is reduced, as described above. However, this embodiment does not minimize average power consumption as much as other possible embodiments.

FIG. 7 is a block diagram illustrating another embodiment of the present invention in whichamplifier140,receiver190,mixer205, fist and second low pass filters245 and265, andtelemetry285 are all turned off during the idle period. The strobing control signal atnode370 is electrically coupled to switchably control, either independently or in groups, the conductances between each ofamplifier140,receiver190,mixer205, first and second low pass filters245 and265, andtelemetry285 and their respective power supplies. Since more components are powered down during the idle period, this embodiment decreases average power consumption further from that of FIG. 6, but stabilization time may be increased, as explained above.

FIG. 8 is a block diagram illustrating another embodiment of the present invention in whichoscillator110,amplifier140,receiver190,mixer205, first and second low pass filters245 and265, andtelemetry285 are all turned off during the idle period. The strobing control signal atnode370 is electrically coupled to switchably control, either independently or in groups, the conductances between each of oscillator10,amplifier140,receiver190,mixer205, first and second low pass filters245 and265, andtelemetry285 and their respective power supplies. FIG. 8 uses acontrol circuit400, which is illustrated in more detail in FIG.9. Since more components are powered down during the idle period, this embodiment decreases average power consumption further from that of FIGS. 6-7.

FIG. 9 is a block diagram illustrating in more detail thecontrol circuit400 of FIG.8. In FIG. 9, a separate timing generator410 is provided for coupling a clock signal throughnode365 todigital control logic355. As in the embodiments illustrated in FIGS.1 and6-7, at least a portion of the digital control logic remains powered during the idle period in the embodiment illustrated in FIGS. 8-9. In the embodiment illustrated in FIGS. 8-9, the timing generator410 also remains powered during the idle period. Timing generator410 is capable of being operated at a lower frequency than the ultrasonic frequencies ofoscillator110. Use of timing generator410 allows thehigher frequency oscillator110 to be powered down during the idle period. This results in further average power savings in some implementations of the present invention.

Thus, the invention described above in FIGS. 1-9 provides a method of estimating the velocity of blood flow in a blood vessel. At least part of the measurement circuits are automatically activated only during the time an estimate is being obtained. At least part of the measurement circuits are deactivated during the time an estimate is not being obtained. These steps are performed repeatedly to provide a sequence of blood flow estimates forming a blood flow waveform indicative of blood flow. More than one estimate is required to obtain the blood flow waveform.

According to one embodiment of the present invention, ultrasonic energy is repeatedly applied to the blood flow in the blood vessel, either periodically or at irregular time intervals over a period of time, such as during all or a portion of one or more cardiac cycles. A portion of the applied energy is reflected from the blood flow to produce a reflected ultrasonic energy signal. The reflected ultrasonic energy is received for further processing from which blood flow velocity is measured. Electronic circuits are powered off or down between the repeated applications of ultrasonic energy, thereby allowing increased levels of illumination while maintaining or reducing average power consumption.

As described above, one embodiment of the present invention uses strobed ultrasonic energy, which advantageously reduces its average power consumption because portions of the present invention are powered off between strobing instances. This advantage, or a portion thereof, may be traded for improved signal-to-noise ratio (SNR), which is also a desirable characteristic for accurate measurement of blood flow velocity. For example,transducer160 is capable of providing higher level illumination ofblood vessel105 than in a conventional system, because strobed ultrasonic energy is used, i.e. the higher level illumination is limited to a shorter duration. Sinceblood vessel105 is illuminated at a higher level, more reflected energy is available for detection, thereby improving the SNR.

Similar signal processing improvements are also available, for example, by using higher supply currents for shorter durations in those other blocks that are capable of being powered down during the idle period, such asreceiver190,mixer205, and first and second low pass filters245 and265. These signal processing improvements obtained from higher current levels for shorter durations include better noise performance and higher bandwidth These improvements provided by the present invention are particularly advantageous for thereceiver190 andmixer205 blocks, which require bandwidths capable of accommodating a Doppler-shifted signal centered around the 5-20 MHz carrier frequency. Thus, the strobed ultrasonic blood flow velocity measurements of the present invention offer considerable advantages in addition to reduced average power consumption.

Trading off the average power savings of the strobed CW Doppler system of present invention for higher power during the active period is further illustrated by way Example 1, comparing the present invention to a conventional CW Doppler system

EXAMPLE 1

	Conventional CW Doppler	Strobed CW Doppler
	Iavg= 2mA	Iavg= 2mA
		tstrobe= 20 ms (50 Hz strobing)
		ton= 2 ms
		toff= 18 ms
		Iidle= 500 μA during toff
		Iactive= 15.5 mA during ton

Example 1 illustrates, for a 50 Hz strobing frequency and (t_on/t_strobe)=10%, the strobed current can be as high as 15.5 mA for an idle current of 500 μA. Thus, in this example, the current can be elevated by a factor of 7.75 in the strobed CW Doppler system without increasing the average power consumption over a conventional CW Doppler system.

FIG. 10 is a block diagram illustrating another embodiment of the present invention in which animpedance matching network450 has been interposed betweenamplifier output150 and transducerelectrical input155.Network450 includes passive impedance matching components to maximize power transfer betweenamplifier140 andtransducer160 at the carrier frequency, whereamplifier140 typically presents an impedance that is unmatched to that oftransducer160.

The impedance matching network results in more efficient power transfer at the output ofnetwork450 atnode165B for the strobed CW Doppler system of the present invention over a conventional CW Doppler system, as illustrated in Example 2.

EXAMPLE 2

Conventional CW Doppler	Strobed CW Doppler
Zout= 2000Ω at carrier frequency	Zout= 400Ω at carrier frequency
Ztran= 20Ω at carrier frequency	Ztran= 20Ω at carrier frequency
Znetwork= 100 to 1 matching	Znetwork= 20 to 1 matching
Iamp= 1 mA peak	Iamp= 5 mA peak during active
	period
Vamp= 4Vp-pcontinuous	Vamp= 4 Vp-pduring active period
Pamp= 1 mW	Pamp= 10 mW
Ptransducer= 1 mW	Ptransducer= 10 mW
Vtransducer= 0.25 Vp-p	Vtransducer= 0.89 Vp-p

In Example 2: Z_outis the output impedance ofamplifier140 atamplifier output150 at the ultrasonic carrier frequency; Z_tranis the impedance oftransducer160 at the carrier frequency; Z_networkis the impedance matching ratio ofnetwork450; I_ampis the peak output current ofamplifier140; V_ampis the peak-to-peak output voltage ofamplifier140; P_ampis the power output ofamplifier140; P_transduceris the power input oftransducer160; and, V_transduceris the peak-to-peak input voltage oftransducer160.

In Example 2, the conventional CW Doppler system is operated continuously, and the strobed CW Doppler system is operated at a 10% duty cycle (t_on/t_strobe) with the negligible current during the idle period. As seen in Example 2,amplifier140 andnetwork450 of the strobed Doppler system of FIG. 10 allow higher power output fromamplifier140, and a higher input voltage oftransducer160. This produces a higher level illumination, resulting in more reflected ultrasonic energy, and thereby improving the SNR.

FIGS. 1-10 illustrate various embodiments of the present invention in which the basebanded I and Q Doppler signals are telemetered to other circuits for further processing to determine the blood flow velocity estimate. In one embodiment, for example, the basebanded I and Q Doppler signals are telemetered from an implanted portion of theblood flow meter100 to accompanying external circuits for further processing. However, signal processing of the basebanded I and Q Doppler signals can also be carried out within the implantedblood flow meter100.

FIG. 11 is a block diagram illustrating an embodiment of the present invention in which asignal processor470 is contained within the implantedblood flow meter100. In FIG. 11,signal processor470 receives the basebanded I and Q Doppler signals atrespective nodes275 and280, and produces a blood flow output signal or velocity output signal representing the estimated blood flow velocity. The velocity output signal is electrically coupled throughnode475 totelemetry285, where it is transmitted from the implantedblood flow meter100 to an external receiver.

FIG. 12 is a block diagram illustrating one embodiment ofsignal processor470 that is particularly useful in applications having a single-ended power supply, such as a battery in the implantableblood flow meter100 of the present invention. In FIG. 12,signal processor470 contains avoltage reference500, which provides a stable output bias voltage atnode505 to a first input of each of first andsecond amplifiers510 and520 and first and second zerocross detectors530 and540. First andsecond amplifiers510 and520 provide gain, or provide both gain and level-shifting. First and second amplifiers may also be used to provide bandpass filtering. A second input offirst amplifier510 receives the basebanded I Doppler signal atnode275. A second input ofsecond amplifier520 receives the basebanded Q Doppler signal atnode280.

First amplifier510 provides a buffered basebanded I Doppler signal at node545 to a second input of first zerocross detector530.Second amplifier520 provides a buffered basebanded Q Doppler signal atnode550 to a second input of second zerocross detector540. First and second zerocross detectors530 and540 provide first and second zero cross outputs atrespective nodes555 and560. The first and second zero cross outputs atrespective nodes555 and560 each change logic state in response to the voltage of respective buffered I and Q Doppler signals passing through the bias voltage atnode505. Each of the resulting pulsatile voltages waveforms at the first and second zero cross outputs is approximately 90 degrees out of phase with the other, and is at the basebanded Doppler frequency.

Quadrature encoder565 receives the first and second zero cross outputs atrespective nodes555 and560. The 90 degree phase difference between the voltage waveforms atnodes555 and560 make it possible to determine their phase relationship at each logic voltage transition of these voltage waveforms atnodes555 and560.Quadrature encoder565 contains logic circuitry for determining the phase relationship between the first and second zero cross outputs atnodes555 and560, and does so at each voltage transition at each ofnodes555 and560. In response to each such determination,quadrature encoder565 provides a fixed-duration voltage pulse to only one offorward node570 orreverse node575.

Differential frequency-to-voltage converter580 receives voltage pulses at each of the respective forward and reversenodes570 and575, and provides a resulting blood flow output signal such as the analog velocity output signal atnode475. In one embodiment,converter580 provides charge integration of the fixed-duration voltage pulses at each of the respective forward and reversenodes570 and575, and provides the resulting blood flow output signal in response thereto. The charge of the voltage pulses at theforward node570 incrementally increases the velocity output signal atnode475, and the charge of the voltage pulses at thereverse node575 incrementally decreases the velocity output signal atnode475.Converter580 could also be implemented as an up-down counter providing an output count representative of the velocity output signal. Voltage pulses received atforward node570 increment the output count, and voltage pulses received atreverse node575 decrement the output count, or vice versa.

Thus,signal processor470 is capable of providing, using a single-ended power supply, an analog velocity output signal atnode475 containing both magnitude and directional information of blood flow velocity. The analog velocity output signal atnode475 can be repeatedly sampled to provide a sequence of blood flow estimates forming a blood flow waveform indicative of blood flow. The analog velocity output signal atnode475 or the samples derived therefrom can be further processed and transmitted from the implantedblood flow meter100.

FIGS. 1-12 illustrate various bidirectional embodiments of the present invention that are capable of determining the magnitude and direction of blood flow velocity. If direction information is not needed, a unidirectional embodiment of the present invention could be used. In a unidirectional embodiment of the present invention, one of the I or Q channels is omitted. Inmixer205, a quadrature phase splitter300 is omitted and only one of first andsecond multipliers305 and310 is needed. Insignal processor470,quadrature encoder565 is replaced by a monostable oscillator (one-shot) providing a fixed-duration pulse, and differential frequency-to-voltage converter580 is replaced by a single-ended frequency-to-voltage converter.

The present invention has been described above with respect to a particular embodiment of strobed ultrasonic Doppler blood flow meter, i.e. a strobed continuous wave (CW) ultrasonic Doppler blood flow meter, referred to as a strobed CW Doppler blood flow meter. However, it is understood that the present invention is also broadly applicable to any embodiment of a strobed ultrasonic Doppler blood flow meter and its method of use.

For example, the invention encompasses the use of a strobed ultrasonic pulsed Doppler blood flow meter, referred to as a strobed pulsed Doppler blood flow meter. The strobed pulsed Doppler embodiment also periodically illuminates a blood vessel by a transducer, but each illumination comprises bursts of pulsatile (or pulse train) ultrasonic-frequency energy. Each burst of ultrasonic-frequency energy from a particular illumination is reflected, or backscattered, from the blood flow and typically subsequently detected at the same transducer. Samples of the resulting electrical signal, each corresponding to a burst of pulsatile ultrasonic-frequency energy, are used to estimate mean frequency. A resulting blood flow velocity estimate is produced from the aggregation of mean frequency estimations within a particular strobing.

FIG. 13 illustrates generally a comparison of the strobed ultrasonic frequency signal waveforms used in each of the strobed CW and strobed pulsed Doppler embodiments. In FIG. 13, thestrobing control signal370V illustrates generally the active and idle periods in relation to the strobing period. The CW embodiment provides anultrasonic frequency signal145V continuously over the entire active period or at least some portion thereof. The strobed pulsed Doppler embodiment provides a pulsedultrasonic frequency signal600 that typically contains more than one burst of pulsatile ultrasonic-frequency energy over the active period or at least some portion thereof.

In fact, as illustrated in FIG. 13, the type of ultrasonic energy signal used is not essential to the invention. Thus, both of the above-described ultrasonic blood flow meters have characteristics that include: repeatedly illuminating the blood vessel with ultrasonic energy during a cardiac cycle; repeatedly receiving during the cardiac cycle an ultrasonic energy signal, which contains Doppler-shifted frequencies corresponding to a blood flow velocity estimate, reflected from the blood flow; and, processing the received ultrasonic energy signal to obtain the blood flow velocity estimate from the Doppler-shifted frequencies contained therein.

In both species of strobed ultrasonic blood flow meters, the ultrasonic energy is strobed repeatedly throughout the cardiac cycle or other period of interest, with a strobing frequency which is substantially lower than the ultrasonic energy frequency. In one embodiment of the present invention, each strobing instance corresponds to a resulting blood flow velocity estimate.

The above-described embodiments describe a blood flow meter that estimates blood flow velocity by strobed Doppler measurements of backscattered ultrasonic energy. However, the strobed blood flow meter according to the present invention also includes other techniques of estimating blood flow velocity, including, but not limited to: transit time measurements, electromagnetic flow measurements, thermal dilution measurements, and laser Doppler measurements, each of which is described further below.

FIG. 14 is a generalized schematic illustration of one embodiment of a transit time measurement of blood flow velocity that is encompassed by the present invention. First andsecond transducers650 and655, respectively, are configured for ultrasonic communication therebetween via anacoustic reflector660. A firstultrasonic impulse665 is launched fromfirst transducer650, reflected fromreflector660, and received atsecond transducer655. A secondultrasonic impulse670 is launched fromsecond transducer655, reflected fromreflector660, and received atfirst transducer650.

FIG. 14 illustrates the case wherefirst impulse665 has a directional component in the same direction as the blood flow inblood vessel105, andsecond impulse670 has a directional component opposite the direction of blood flow inblood vessel105. As a result, a travel time ofsecond impulse670 fromsecond transducer655 tofirst transducer650 is longer than a travel time offirst impulse665 fromfirst transducer650 tosecond transducer655. Blood flow velocity is calculated from the difference in transit times of the first andsecond impulses665 and670 respectively.

In this embodiment, the invention includes acontrol circuit675 for providing a strobed ultrasonic frequency signal to each of respective first andsecond amplifiers680 and685 throughrespective nodes690 and695.Control circuit675 optionally provides power control signals to respective first andsecond receivers700 and705 throughrespective nodes710 and715. First andsecond amplifiers680 and685, respectively, provide an amplified strobed ultrasonic frequency signal atrespective nodes720 and725 to respective first andsecond transducers650 and655, which provide the first andsecond impulses665 and670 in response thereto.

First andsecond transducers650 and655 also receive respective second andfirst impulses670 and665, as described above, and provide resulting electrical signals to respective first andsecond receivers700 and705 throughrespective nodes730 and735. First andsecond receivers700 and705, respectively, provide buffered electrical signals toprocessing circuit740 throughrespective nodes745 and750.Processing circuit740 calculates blood flow velocity from the difference in transit times of the first andsecond impulses665 and670 respectively, and provides through node755 a signal containing blood flow velocity information totelemetry device760 for transmission to a remote telemetry device.Control circuit675 optionally provides a power control signal toprocessing circuit740 through node765 for reducing or removing power from processingcircuit740 between transit time estimates of blood flow velocity. As described above,control circuit675 may also optionally provide a power control signal totelemetry device760 to reduce or remove power fromtelemetry device760 when it is not transmitting a transit time estimate of blood flow velocity.

FIG. 15 illustrates an end view of the configuration of FIG.14. In FIG. 15, first andsecond transducers650 and655, respectively, andreflector660 are arranged such that first andsecond impulses665 and670, respectively, each provide aninsonification area770 that includes the entire area ofblood vessel105, such that an average estimate of blood flow over the area ofblood vessel105 is provided. The transit time estimate of blood flow velocity may also be improved by averaging multiple transit time measurements to provide a single estimate of blood flow velocity. In such an embodiment,control circuit675 reduces or removes power from other circuits between each series of transit time measurements used to provide a blood flow velocity estimate. A sequence of blood flow estimates forms a waveform representative of blood flow over a period of time.

The present invention also includes the use of electromagnetic flow techniques to estimate blood flow velocity. In one embodiment of this technique, first and second electrodes are disposed across an interposed blood vessel such that the blood flow is in a direction that is substantially orthogonal to a vector between the first and second electrodes. A permanent magnet or electromagnet is used to create a magnetic field through the blood vessel in a direction that is substantially orthogonal to both the direction of blood flow and the vector between the first and second electrodes. As a result, ionized particles within the blood flow are deflected toward one of the first and second electrodes, resulting in a voltage difference therebetween that is proportional to the blood flow velocity. The invention uses the above-described strobing technique to reduce or remove power between blood flow estimates to circuits within the blood flow meter, such as to the electromagnet, if any, or to sensing and processing circuits that detect the voltage difference between the first and second electrodes, or to telemetry circuits that transmit electromagnetic flow estimates of blood flow velocity to a remote telemetry device.

The present invention also includes the use of thermal dilution techniques to estimate blood flow. In one embodiment of this technique, a heater is used to pulsedly heat the blood, and the heated blood pulse is detected by a temperature sensor located at a known distance from the point of heating in the direction of the blood flow. Volumetric blood flow is calculated from the time between the heating of the blood pulse and the detection of the blood pulse. Several heated blood pulses are typically introduced and detected to produce a more accurate blood flow estimate.

In another embodiment of this technique, a single thermistor is used for both heating and detection. A heated thermistor is introduced into the blood vessel such that it is in thermal contact with the blood flow, and cooling of the thermistor is effected by the blood flow. Blood flow at a higher velocity cools the thermistor at a higher rate than blood flow at a lower velocity. The energy delivered to the thermistor to maintain the thermistor at a constant temperature is proportional to blood flow velocity. Alternatively, the thermistor can be heated to a known temperature, and the time required to cool the thermistor to a second, lower temperature will be inversely proportional to blood flow.

According to the present invention, measuring circuits in the above-described thermal dilution embodiments are automatically activated only during estimation of blood flow, and are powered down or off between estimates of blood flow. A resulting volumetric blood flow vs. time waveform constructed from the sequence of blood flow estimates is thereby obtained at a reduced power consumption by application of the strobing technique of the present invention.

The present invention also includes the use of laser Doppler techniques to estimate blood flow. The blood flow is illuminated with a coherent monochromatic light source signal. A resulting backscattered Doppler-shifted light signal is received at an optical detector, and demodulated such as by mixing with the monochromatic light source signal. Blood flow velocity is estimated from a resulting basebanded Doppler-shifted frequency of the received light signal. According to the present invention, measuring circuits, optionally including the monochromatic light source, are automatically activated only during estimation of the blood flow velocity. These measuring circuits are deactivated, i.e. powered down or off between estimates of blood flow velocity. A resulting velocity vs. time waveform constructed from the sequence of blood flow velocity is thereby obtained at a reduced power consumption by application of the strobing technique of the present invention.

Thus, the present invention provides an strobed blood flow meter, such as an implantable strobed ultrasonic Doppler blood flow meter, having reduced average power consumption, which is advantageous for reducing battery size, improving signal-to-noise ratio, and extending battery life.

It is to be understood that the above description is intended to be illustrative, and not restrictive. Many other embodiments will be apparent to those of skill in the art upon reviewing the above description. The scope of the invention should, therefore, be determined with reference to the appended claims, along with the fill scope of equivalents to which such claims are entitled.

Claims (10)

What is claimed is:

1. A method of repeatedly estimating fluid flow in a conduit, the method comprising the steps of:

(a) illuminating the conduit with ultrasonic energy for an active period of a control signal sufficient to obtain an estimate of fluid flow;

(b) receiving an ultrasonic energy signal using one or more measurement circuits in response to illuminating the conduit with ultrasonic energy;

(c) processing the received ultrasonic energy signal using the one or more measurement circuits to obtain a fluid flow estimate;

(d) interrupting step (a) for at least a portion of an idle period of the control signal; and

(e) reducing power to at least a portion of the one or more measurement circuits during the portion of the idle period.

2. The method ofclaim 1, further comprising repeating steps (a)-(d) over a period of time.

3. The method ofclaim 2, wherein repeating steps (a)-(d) includes repeating steps (a)-(d) at a strobing frequency greater than approximately 50 Hz.

4. The method ofclaim 1, wherein the active period in step (a) is longer than a stabilization time.

5. A method of repeatedly estimating fluid flow in a conduit, the method comprising the steps of:

(a) powering up electronic circuits to receive and process a signal representative of fluid flow in the conduit to produce a fluid flow estimate during an active period of a control signal;

(b) illuminating the conduit with ultrasonic energy from at least two sources to produce first and second signals during at least a portion of the active period;

(c) receiving the first and second signals containing time-shifted frequencies and

(d) reducing power to the electronic circuits during at least a portion of an idle period of the control signal.

6. The method ofclaim 5, further comprising repeating steps (a)-(d) over a period of time.

7. The method ofclaim 5, further comprising powering on an amplifier during step (a).

8. The method ofclaim 5, wherein step (a) comprises powering on a receiver.

9. The method ofclaim 5, wherein a strobing frequency, corresponding to the inverse of a sum of the active and idle periods, is greater than approximately 50 Hz.

10. The method ofclaim 5, wherein step (a) comprises powering on a processing circuit.

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